Biomedical subjects
Publications and source records attributed to R Robert.
A case of acute respiratory failure revealing amyotrophic lateral sclerosis is reported. The other neurological diseases with diaphragmatic paralysis are recalled.
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Several strains of Chrysosporium keratinophilum and Anixiopsis stercoraria agglutinate the red blood cells of different origins (man, sheep, rabbit, mouse). The best agglutination was obtained with rabbit erythrocytes. The inhibition experiments by carbohydrate solutions (oses, osamines and glycoproteins) were performed with 3 haemagglutination units of these fungi and revealed the lectin nature of this haemagglutinin, as evidenced by the specific inhibiting activity of N-acetyl-neuraminic acid. Preliminary studies seemed to indicate that this lectin is a thermostable protein, and that the haemagglutination activity is calcium-dependent.
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A convergent postburn psychopharmacologic treatment for children for acute stress disorder (ASD) symptoms has not been established. Both the application of what has been learned through treatment of similar symptoms experienced by adults with posttraumatic stress disorder and the examination of safe treatment options for children led to the clinical decision to use imipramine for 25 pediatric patients with acute burns. The treatment histories of these patients were retrospectively reviewed to see if further exploration into the efficacy of imipramine was warranted. Eighty percent of the children experienced remission of hyperarousal symptoms (eg, trouble staying asleep, trouble falling asleep) and intrusive reexperiencing symptoms (eg, nightmares). Twelve percent of the children experienced a decrease in the frequency or intensity of ASD symptoms. Eight percent had no relief of ASD symptoms. Initial findings suggest that imipramine assists children who have postburn ASD symptoms by decreasing the hyperarousal and intrusive reexperiencing symptoms of ASD.
Advances in medical management have dramatically decreased the mortality of children with massive burn injuries, which raises many questions about the expected quality of life for these young survivors. In this article, we address this issue by examining the functional and psychological adaptation of 41 young survivors with 88% mean total body surface area (TBSA) burns and 85% mean third degree TBSA burns. Patient scores were compared with normative data on standardized psychological measures of adjustment and on performance of age appropriate activities of daily living (ADL) skills. Thirty-three of the 41 patients (80%) were independent in basic ADL skills. Eighty-six percent of the patients who were aged 10 years and older were independent in advanced ADL skills. Patients with amputated fingers were significantly more dependent in ADL skills than those without amputations (P < .05). Mean psychosocial adjustment scores were within normal limits and were not significantly related to functional independence in ADL skills.
Very little information has been published about 2- and 3-year-old children who have experienced major burns. This study used a standardized instrument to measure the behavioral adjustment of these young burn survivors, and the results were compared with those of a nonclinical normative sample. Thirty-three pediatric burn survivors with 50%+/-28% total body surface area burns were evaluated 1.2+/-0.7 years postburn. Parental observations were assessed with the use of the Child Behavior Checklist for 2- and 3-Year-Olds, a 99-item standardized checklist designed to identify behavior problems. Forty of the questions are specific to 2- and 3-year-olds, and the scores of male and female children are not differentiated. The raw scores of the children with burns were statistically compared with the reported normative sample for this version of the Child Behavior Checklist. Pediatric burn survivors in this sample exhibited significantly more internalizing behaviors than the children in the normative group. Parents reported children who had been burned to be more depressed and to have more somatic complaints and sleep problems. Determining the relationship of behavior problems to posttrauma sequelae and preburn environmental factors would assist with the establishment of appropriate psychosocial interventions.
This study assessed long-term psychosocial sequelae of young adult pediatric burn survivors. Subjects were 101 young adults (43 females and 58 males) between the ages of 18 and 28 years who were at least 2 years (average, 14 years) postburn at least 30% TBSA (mean = 54 +/- 20%). Educational status was 25% high school dropouts, 28% high school graduation only, 32% some college, and 5% completed college. Seventy-seven percent either worked or attended school; 28% had had a long-term partner. When assessed by Achenbach's Young Adult Self-Report (YASR) scale and compared with its published reference group, the males reported differences only in the somatic complaints, but the females endorsed significantly more externalizing and total problems, specifically withdrawn behaviors, somatic complaints, thought problems, aggressive behavior, and delinquent behavior. Despite these problems suffered by some female pediatric burn survivors, the overall outcome revealed that most pediatric burn survivors are making the transition into adulthood with minimal unexpected difficulty.
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The name of sacro-coccygeal tumors is used generally for various tumors embryologically different in their origin. Rare, but not exceptional in number, these sacro-coccygeal tumors may have various locations and different sizes which make diagnosis more or less difficult. Benign in the first months of life, risks of malignancy will increase with age. Systematical intrarectal exploration will help not to overlook pelvic forms and will recognize pelvic extension in other types. Once found out, the extension of these sacro-coccygeal tumors should be estimated by complementary examination choosen according to the presumed type of tumor and it is to be regretted that myelography should be so often neglected. Treatment should always be surgical with one piece aphotesis if possible; good preparation and exact reanimation of the child are necessary because sometimes surgical treatment may be a very severe aggression for small babies. Constant surgical and biological overall should be maintained for many years in order to discover as early as possible any local relapse or metastasis.
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While a brucellosis disease proved with bacteriological and serological tests, a serodiagnostic of amebiasis using the immunofluorescence techniques has been positive toward a dilution of 1/320. The authors think to have a false positive reaction in amebiasis. Even though the anatomopathological examination of the liver did not show any amoebiasis focus, we can see some histological lesions due to a present or an old brucellosis disease.
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Fifty patients stricken by giardiosis were treated by a single dose administration of Tinidazole -- 50 mg./kg. for children and 2 g. for adults per os. Fifteen days after treatment, 84 0/0 of the patients had negative coprologic exams for giardiosis. The product was well-tolerated by the digestive tract as was demonstrated by a coprologic examination for digested food reside; however, minor digestive inconveniences were noted in 87 0/0 of the patients. There were no perturbations of hematologic or hepatic tests. This product would thus appear to be a treatment of choice in the management of giardiosis.
In 1989, we reported our thoughts on the neurophysiological and anatomic aspects of pudendal nerve involvement in certain types of perinal pain. Since that time, the surgical approach has been modified. Here we report our follow-up of 40 patients with 48 operated nerves. Follow-up ranged from 6 months to 7 years and outcome revealed improvement in 67% and no change in 33%. Thus surgery had been useful in two-thirds of the cases; in 44% of the patients, there was either a frank improvement or no change. Early diagnosis appears to be the determining factor in improving results. Operating for the canal syndrome must be performed before lesions to the nervous trunk become too important.